Provider Demographics
NPI:1720797350
Name:MCKINLEY, ALLISON NICOLE (DPT)
Entity Type:Individual
Prefix:DR
First Name:ALLISON
Middle Name:NICOLE
Last Name:MCKINLEY
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:NICOLE
Other - Last Name:GREER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:1224 PULLMAN RD APT 102
Mailing Address - Street 2:
Mailing Address - City:ROMEOVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60446-4199
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1049 LAKE ST STE 201
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60301-6708
Practice Address - Country:US
Practice Address - Phone:708-607-6040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-22
Last Update Date:2022-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070.027124225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist